Cardioembolic stroke secondary to Lambl's excrescence on the aortic valve: a case report.

We report a patient who presented with aphasia and was found to have an embolic cerebral infarction secondary to LE. LE is a rare source of cardioembolic stroke.

Managing your practice's first impression: the process of front-desk reengineering.

Patients must be regarded as consumers. As such, they are increasingly informed, questioning, cost-conscious, technologically savvy, and demanding. Just as health plans have developed defined contribution products that offer consumers more control over how and where their health-care dollars are spent, practice success is linked to reengineering office operations to offer consumers and patients greater choice, control, autonomy, and service. Patients and consumers want practices that deliver clinical and business services that meet the criteria of reliability, effciency, service offerings, patient focus, enthusiasm, customization, and trust. Physician practices must also take care to avoid destructive and disruptive behaviors and conditions such as noise, interference, excessive repetition, long waits, appointment delays, and staff rudeness. A successful patient-focused practice emerges when physicians and office staff begin to look at the clinical and service experience through the patient's eyes.